The role of clinical pharmacist to improve medication administration through enteral feeding tubes by nurses
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Background As a common practice, medications are given in addition to nutrients through enteral catheters especially in critically ill patients. Nurses are primarily responsible to administer medications in this manner. The correct drug delivery via enteral tubes requires special skills. Objective This study was designed to evaluate effectiveness of clinical pharmacist-led educational program in progressing nurses’ knowledge and practice regarding medications delivery via enteral catheters. Setting This study has been performed in two teaching hospital affiliated to Tehran University of Medical Sciences. Methods This is a case–control, interventional study. At first, a knowledge and practice questionnaire regarding drug administration trough enteral feeding tube by intensivist nurses was prepared. This questionnaire was filled by each nurse at pre-intervention phase of the study. Then, the clinical pharmacists provided educational programs including preparing evidence-based booklet and classes for case group nurses. Nurses in case and control groups were evaluated again after 3 months. At pre- and post-intervention phases nurses were observed regarding their practice to administer drugs via enteral tubes as well. Main outcomes Mean scores of knowledge and practice questions as well as percent of nurses with correct answers were compared between pre- and post-intervention phases in case and control groups. Results The mean scores of knowledge and practice questions significantly increased in the case group but decreased or remained unchanged in the control group. In contrast to control group, the percent of nurses with correct answers to each domain of knowledge and practice questions increased significantly in the case group. Conclusion This study showed that nurses did not have sufficient baseline knowledge about rules of drug administration via enteral feeding tubes; however, integrated educational program by clinical pharmacists that focus on promoting correct administration of drugs via enteral feeding catheters significantly improved knowledge and practice of nurses. A theory–practice gap was found in this study that may be related to the authority of physicians not nurses in ordering rules for medication administration through enteral catheters.
KeywordsClinical pharmacy Drug administration Enteral feeding tube Iran Knowledge Nurse
The authors wish to thank Dr Gita Salimi, pharmacist; Miss Hamidafar, head-nurse of intensive care unit, Imam Khomeini Hospital Complex, Tehran; and Miss Fatemeh Rabeepoor educational supervisor nurse, Imam-Reza Hospital, Eslamshahr, Tehran for their invaluable helps.
This study was part of a Pharm.D thesis supported by Tehran University of Medical Sciences.
Conflicts of interest
The authors declare no conflict of interest.
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